Active NPI
Jordyn McMillin, SLPA; B.S.
- Speech-Language Assistant
- Marana, AZ
National Provider Identifier
1033847272
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Assistant
- License
- 13687
- Practice address
- 38388 S Fenton Rd
Marana, AZ 85658-8825 - Phone
- (520) 780-4124
- NPI assigned
- Aug 14, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Assistant | 2355S0801X | 13687 | AZ | Primary |
Addresses
Primary practice location
38388 S Fenton Rd
Marana, AZ 85658-8825
Mailing address
38388 S Fenton Rd
Marana, AZ 85658-8825
Phone (520) 780-4124
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13687 | AZ | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1660435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660435200000",
"number": "1033847272",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "38388 S FENTON RD",
"city": "MARANA",
"state": "AZ",
"postal_code": "856588825",
"telephone_number": "520-780-4124"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "38388 S FENTON RD",
"city": "MARANA",
"state": "AZ",
"postal_code": "856588825",
"telephone_number": "520-780-4124"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCMILLIN",
"first_name": "JORDYN",
"credential": "SLPA; B.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-08-14",
"last_updated": "2022-08-14",
"certification_date": "2022-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "2355S0801X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Speech-Language Assistant",
"state": "AZ",
"license": "13687",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marana, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.